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= Stuttering Pride/Advocacy = Stuttering pride (or stuttering advocacy) is a social movement repositioning stuttering as a valuable and respectable way of speaking. The stuttering pride movement challenges the pervasive societal narrative of stuttering as a defect. The movement encourages stutterers to take pride in their unique speech patterns and in what stuttering can tell us about the world. It also advocates for societal adjustments to allow stutterers equal access to education and employment opportunities [1].

Stuttering pride has drawn ideas and inspiration from disability rights, in particular the development of the social model of disability and the neurodiversity paradigm.

Stammering pride foregrounds an emerging stammering culture. Such a stuttering culture highlights the power of creative writers, artists, and musicians to subvert concepts of 'normative' speech through the power of expressive and generative dysfluency.

Stuttering Advocacy
Several grass roots movements have challenged the conventional narratives around stuttering. The 2011 book, “Voice Unearthed: Hope, Help, and a Wake-Up-Call for the Parents of Children who Stutter” described how author Doreen Lenz Holte encountered advice she found on balance counter-productive for her and her child. The book has developed into advocacy for greater understanding by professionals of the needs of families with young stutterers.

For adults, the website “Did I Stutter?” (2014) attracted writings questioning assumptions common in adult stuttering therapy. These included the contention by some therapists that fluency in and of itself should be the primary therapy goal. An early culmination of the grass roots movement was the 2019 publication, “Stammering Pride and Prejudice: Difference not Deficit”, which collected together essays investigating the social model of stuttering.

Two of the longest-running grass roots campaigns are the websites Stutter Talk and Stuttering is Cool. Stutter Talk is a podcast series, with over 600 episodes published between 2007 and 2021. Stuttering is Cool follows the adventures of an anthropomorphic fox who stutters. The fox, Franky Banky, frequently refers to stuttering in a positive and/or humorous manner (e.g. “I stutter. So what?”; “Sure I stutter. What are you good at?”). Speech and language therapists have used Stuttering is Cool in therapy sessions to generate discussion with child and adult clients, art therapy, role playing, and talking about stuttering with parents of children who stutter.

Charities for stuttering have traditionally been based around information, therapies and interpersonal contact (e.g. workshops, open days and conferences). Several charities have introduced a greater advocacy component. Stuttering Association for the Young (SAY) delivers camps developing confidence and independence for children who stutter in the USA and Australia. These include prominent positive messaging such as “It’s OK to stutter”. The British Stammering Association launched a campaign, STAMMA, in 2018 which aims to change attitudes to stuttering. An example is the 2020 “Find the Right Words” campaign, created with advertising agency VMLY&R. The campaign edited Wikipedia entries for well-known personalities who stutter, removing negative language which had formerly been associated with their stuttering. Another initiative from the UK, 50 Million Voices, launched in 2019 and seeks to create a worldwide network of business leaders who will tackle structural discrimination against stuttering in the workplace. Practice interview events organised by 50 Million Voices showcase the skills of people who stutter to prospective employers, providing benefits to individuals and organisations.

Criticisms
The stuttering pride movement has attracted some criticisms. Some people have felt that the movement denies the reality of the difficulties of life with a stammer (Constantino, Campbell, Simpson article). It could also in its efforts to de-medicalise stuttering take funding away from researchers and therapists who are attempting to genuinely alleviate the pain and challenges of stuttering through medical means, as well as taking agency away from people who stutter to change how they speak themselves.

Another critique is that its ideals and concepts come from Western, primarily white and privileged perspectives. It could be seen as failing to identify and engage in the intersectional challenges people who are not white and otherwise abled-bodied may face when attempting to be proud of their speech. In particular, stuttering pride advocacy may be particularly difficult to apply in societies with more limited or no legal protections around disability.

Implications for Stuttering Therapy
Stuttering pride has challenged some of the fundamental concepts that used to historically underlie speech and language therapy. There has been recent discussion on the ideals and methods of therapy for people who stutter in part sparked by stuttering pride. There has been a particular focus on the models of disability (medical and social) that underlie stuttering therapy and consequently the approach in therapy that comes from that. Medical Model of Disability

Medical Model
The medical model views the disability of the individual as occurring due to the underlying impairment, loss of function or pathology of the individual. Intervention within a medical model approach aims to fix, cure or eradicate the pathology. For people who stutter, a medical model approach has historically led to interventions for stuttered speech being centred around fluency  (de Sonneville-Koedoot et al., 2015). The diagnostic categorisation used in a medical model framework has value in research contexts to enable accurate identification and categorisation needed for clinical research design. The medical model can provide a point of reference for ‘the norm’ to enable applications for supports and accommodations arising from disability. Criticism of a medical model approach to stuttering has included its designation of fluent speech as the desired norm together with a pathologisation of stuttering, perpetuating the belief that stuttered speech is ‘broken’ and in need of ‘fixing’. In this framework, stuttered speech is perceived as disordered and dysfluent, thereby defined by what it is not rather than what it is and stigmatised. The privileging of fluency places the onus to change solely on the speaker and prioritises ableist listener outcomes.

The Social Model
The social model of disability positions disability within wider society rather than the individual in isolation. Societal barriers and prejudices are considered to be the cause of disability, rather than an individual’s impairment, due to the world being designed for a specific/standard body type and therefore unable to accommodate any variations to this norm. From a social model perspective, the disability experienced by people who stutter is due to societal expectations and fluency norms, stigmatised perceptions and societal narratives about stuttered speech and environmental and structural barriers in society that exclude stuttered voices (e.g. voice automated telephone systems and time limited interview practices). If these societal barriers were removed, then people who stutter may experience less self-stigma about stuttering and have improved quality of life. P1, P2, P3

Impact on speech and language therapy
In the field of of Speech and language therapy, there has historically been a heavy focus on the production of fluent speech and a reduction or elimination of stuttered speech. The measurement of therapy outcomes were often based on counting the number of syllables stuttered with therapy goals aiming to reduce this percentage. Additionally, Speech-Language Pathologists|Speech and Language Therapists work with people who stutter to explore the emotions, attitudes, self-stigma and societal stigma about stuttering/stuttering. Indeed, there have previously been seen to be two broad philosophies within the field of Speech and language therapy distinguishing between the speak-more-fluently and stutter-more-fluently approaches: the former broadly-speaking focusing on fluency-shaping and speech re-structuring and the latter on reducing avoidance/masking and negative attitudes towards stuttering as well as modifying moments of stuttering. These two philosophies have directly shaped therapy practice, research priorities and services offered resulting in significant variations in the dominant approach adopted in different countries across the world.

The social model of disability has created the foundations for a new wave of therapy, central to this is a commitment to people who stutter becoming equal partners in research and co-producers of therapy knowledge. For these speech and language therapists, the focus of therapy outcomes is shifting away from such a focus on fluency techniques and psychological interventions towards advocacy and allyship.

Speech therapy using a social model framework does not solely focus on reducing stuttering or striving for fluent speech but advocate techniques to move forwards and reduce tension when speaking. Therapy within a social model context examines the role of stigma and identity, self-acceptance, advocacy. Therapy outcomes are associated with increased participation in preferred activities, a reduction in avoidance or masking of stuttering, increased confidence to openly stutter, increased comfort in speaking and more spontaneity in everyday interactions.

Neurodiversity and stuttering pride
"Neurodiversity advocates generally consider autism to be both a natural variation and a disability. Advocates therefore concurrently campaign for acceptance and respect for autistic people as valuable members of society and also fight for appropriate support and services to meet the needs of the autistic community.” (den Houting, J. (2019)P10.

The neurodiversity movement, particularly prominent in the autistic community, has led some in the stuttering community to push for stuttering to be seen as a difference rather than a defect or impairment (a movement called stuttering pride). Stuttering pride activists advocate for acceptance and respect of stuttered speech. Some have spoken against speech and language therapy approaches that encourage fluent speech as ableist and unhelpful to those who stutter. P16

“It is important that a social or cultural model does not entirely exclude medicine or speech therapy, but that we use it to ask critical questions about how some of the assumptions of a curative model of speech might injure dysfluent individuals.” (St. Pierre, 2014)P11 Ableism within speech and language therapy

“Ableism is the assumption that people are better off as able-bodied, or without physical, mental, or sensory impairments, and any deviation from this able-bodied ideal constitutes a loss.” (Gerlach-Houck and Constantino, 2021)

The social model of disability and neurodiversity have encouraged speech and language therapists to look at their own practice for any language or methods that might stigmatize stuttering. Some within the profession have highlighted work within their own profession which is overtly or covertly ableist. There is consideration given to removing clinical microaggressions that demean stuttered speech, such as “Well done, you sounded so smooth and fluent” or “I didn’t hear you stutter at all just then!”. Some SLPs/SLTs are auditing the language they use to describe communication differences and therapy interventions, as well as considering the ethics of fluency based therapy approaches. Allyship in speech and language therapy Speech and language therapists are crucial allies to people who stutter in society. The saying “Nothing about us without us” used by various disability rights groups asks for the members of the ‘disabled’ community to have an active voice and participate in research, therapy, cultural narratives and resources. The lived experiences of people who stutter need to be heard to ensure the community has an active role in social, cultural, political, scientific and health-related discussions. To further amplify their message, the importance of allies to the stuttering community has been openly acknowledged P20 P21. As allies to those who stutter, some speech and language therapists see their role as more far reaching than individual clinical work. They have been drawn to advocating for awareness and acceptance of speech diversity, challenge misinformation, draw attention to ableism and ableist practices, call out microaggressions, dispel myths about stuttering, and get involved by supporting campaigns led by the stuttering community. Sources P1 Rembis, M. (2019). Challenging the impairment/disability divide: Disability history and the social model of disability. In Routledge Handbook of Disability Studies (pp. 377-390). Routledge. P2 Bailey, K., Harris, S. J., & Simpson, S. (2015). sStammering and the social model of disability: Challenge and opportunity. Procedia-Social and Behavioral Sciences, 193, 13-24. P3 Simpson, S., Campbell, P., & Constantino, C. (2021). Stammering: Difference Not Defect. P4 https://www.isastutter.org/stuttering-as-a-disability-the-controversy P5 https://stamma.org/about-stammering/stammering-disability#:~:text=For%20others%2C%20their%20stammering%20is,%2Dto%2Dday%20activities'. P6 Singer, J. (1999). Why can’t you be normal for once in your life?: from a “Problem with No Name” to a new category of disability. In Corker, M and French, S (Eds.) Disability Discourse Open University Press UK P7 Blume H. Neurodiversity. The Atlantic. September 30, 1998. http://www.theatlantic.com/magazine/archive/1998/09/neurodiversity/305909/. Accessed February 18, 2015. P8 Singer J, (1998) Odd People In: The Birth of Community Amongst People on the Autism Spectrum: A personal exploration of a New Social Movement based on Neurological Diversity. An Honours Thesis presented to the Faculty of Humanities and Social Science, the University of Technology, Sydney. P9 Singer, J. (2016) NeuroDiversity: the birth of an idea. Available Kindle Online. P10 den Houting, J. (2019). Neurodiversity: An insider’s perspective. Retrieved from: Neurodiversity: An insider’s perspective Jacquiline den Houting, 2019 (sagepub.com) P11 https://www.didistutter.org/blog/the-medical-model-of-speech-mapping-out-the-limitations-of-an-outdated-framework P12 Beck JS, Lundwall RA, Gabrielsen T, Cox JC, South M. Looking good but feeling bad: “Camouflaging” behaviors and mental health in women with autistic traits. Autism. 2020;24(4):809 821. doi:10.1177/1362361320912147 P13 Cassidy, S. A., Gould, K., Townsend, E., Pelton, M., Robertson, A. E., & Rodgers, J. (2019a). Is camouflaging autistic traits associated with suicidal thoughts and behaviours? Expanding the interpersonal psychological theory of suicide in an undergraduate student sample. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803 019 04323 3. P14 Cassidy, S.A., Robertson, A., Townsend, E. et al. Advancing Our Understanding of Self harm, Suicidal Thoughts and Behaviours in Autism. J Autism Dev Disord 50, 3445 3449 (2020). https://doi.org/10.1007/s10803 020 04643 9 P15 Crane L, Adams F, Harper G, Welch J, Pellicano E. ‘Something needs to change’: Mental health experiences of young autistic adults in England. Autism. 2019;23(2):477 493. doi:10.1177/1362361318757048 P16 https://stamma.org/your-voice/medical-vs-social-model-disability-it-shouldnt-be-either-or P17 Cook, J., Hull, L., Crane, L. and Mandy, W. Camouflaging in autism: A systematic review, Clinical Psychology Review, Volume 89. (2021),https://doi.org/10.1016/j.cpr.2021.102080. P18 Gerlach H, Chaudoir SR, Zebrowski PM. Relationships between stigma-identity constructs and psychological health outcomes among adults who stutter. J Fluency Disord. 2021 Dec;70:105842. doi: 10.1016/j.jfludis.2021.105842. Epub 2021 Mar 6. PMID: 33713942. P19 https://www.inclusionlondon.org.uk/disability-in-london/social-model/the-social-model-of-disability-and-the-cultural-model-of-deafness/ P20 http://isad.isastutter.org/isad-2017/papers-presented-by/creative-expression/how-to-be-a-fluent-ally-to-people-who-stutter-an-illustrated-guide/comment-page-1/ P21 https://westutter.org/wp-content/uploads/ally-2019.pdf P22 https://www.stutteringhelp.org/blog/recruiting-fluent-allies

Stuttering as a positive in culture Typical reports of stuttering in culture highlight individuals who have ‘overcome’ stuttering or for whom it is surprising to find out stutters due to their prominent position. Instead, stuttering pride advocates look to highlight stuttering's positive role in culture, both as a generative experience for individuals who stutter in their art and/or stuttering as a musical or literary device in of itself. Literature Many celebrated writers were stutterers. A notable writer of the nineteenth century who stuttered was Lewis Carroll (i.e., Charles Lutwidge Dodgson). Alice's Adventures in Wonderland is thought to be his first art piece to be influenced by stuttering. Lewis Carroll's use of portmanteau words throughout his work is believed to be a consequence of stuttering [ref Jacques de Keyser: 'The Stuttering of Lewis Carroll']. Lewis Carroll's portmanteaus can be found in the poems Jabberwocky and The Hunting of the Snark. For example, they include words such as: 'galumphing', a combination of gallop and triumphant ("He left it dead, and with its head He went galumphing back."); 'frumious', a combination of fuming and furious ("frumious Bandersnatch"); and 'chortle', a combination of chuckle and snort ("He chortled in his joy.")

Another writer of the late nineteenth and early twentieth century who stuttered was Henry James. Similarly to Lewis Carroll, the physical nature of stuttering influenced the form of art of Henry James. Henry James' later writings differ from his earlier work by using lengthier and more verbose sentences that do not expose the verb until later in the sentence. The sentences in his later writings also include many qualifying adverbs, conjunctions, and sentence connectors. [ref Robert G. Johnson: A study of the style of Henry James's late novels]. These style changes in his later writings took place when James switched to typewritten dictation. Henry James' late style is argued to be a result of an interiorised stutter, which resulted in camouflaging anticipated stuttered words by carefully considering a vast vocabulary of words [ref Words Fail Us]. In addition, James' late style is considered to have influenced other novelists that followed him, fundamentally changing the shape of literature.

Somerset Maugham was an author of the twentieth century who stuttered. In the case of Somerset Maugham, stuttering influenced what he had to say in his work, rather than how he conveyed his messages. Stuttering is said to have impacted the tone and atmosphere of Maugham work [ref Words Fail Us], which are believed to convey the loneliness and stigma he experienced due to stuttering [ref Words Fail us]. Although the loneliness that surrounds Maugham's writing is usually linked to his sexuality, Maugham has declared that stuttering greatly influenced his life and work [ref: Ted Morgan: Somerset Maugham, 1980].

Finally, other late writers’ work in which stuttering influenced how they conveyed their message and what they had to say include George MacDonald (author of The Princess and the Goblin), Charles Kingsley (author of The Water-Babies), and Elizabeth Bowen (author of The Death of the Heart and The Heat of the Day).

A contemporary writer who stutters is David Mitchell. David Mitchell stated that stuttering influenced him to become a writer [David Mitchell, 'Let me Speak', Telegraph (30 April 2006)]. He argued that stuttering deepens one's connection with language. As a result, the interior use of the language of stuttering writers can be richer than their exterior use of language, which often results in greater command of language structures and vocabulary [ref] [ref YouTube video?].

A current writer and poet who stutters is Owen Sheers. Owen Sheers also stated that stuttering influenced him to become a writer [ref]. He argues that stuttering increased his awareness of words and language, allowing him to extend his vocabulary by making him more sensitive to words' weight, significance, and resonance [ref YouTube video].

Similarly, Zaffar Kunial, a poet who stutters,states that stuttering increased his awareness of the letters each word contains and the many possibilities that a sentence can hold. He argues that his sensitivity to language has been heightened by the experience of stuttering and by feeling like he is not in control [ref YouTube video].

Finally, other writers who stutter include novelist and educator Darcey Steinke (Suicide Blonde); bestselling author and filmmaker David Shields (Reality Hunger: A Manifesto); novelist, poet, sculptor, filmmaker, and performance artist Brian Catling (The Vorrh Trilogy); novelist, biographer, and critic Margaret Drabble (The Millstone); novelist and dramatist Vladimir Sorokin (Day of the Oprichnik); poet and social worker Erin Schick (Honest Speech); and poet and children’s author Jordan Scott (I Talk Like a River). Music There are a number of celebrated musicians who stuttered. One example was blues singer, guitarist, and songwriter B.B. King, one of the most influential blues musicians of all time. B.B. King stuttered since he was a child and used music to communicate. It is argued that the music genre B.B. King used to communicate (the blues) has a special connection with stuttering because of their shared tone and atmosphere, such as experiences of oppression and segregation [ref: B.B. King, Blues All Around Me: The Autobiography of B.B. King (Avon Books, 1996).]

Another blues musician, guitarist, and songwriter who stuttered was John Lee Hooker. Stuttering is featured on the song 'Stuttering Blues', which appears on the album Detroit Special: "Excuse me, baby, I can't get my words out just like I want, but I can get my loving like I want it".

Another musician who stuttered was Scatman John (John Paul Larkin). Larkin uses 'skatting' in his work, an emotive jazz vocal style that uses nonsense syllables instead of words, which later on became known as 'scat-rap'. The song 'Scatman (ski-ba-bop-ba-dop-bop)' armed Larkin with resistance against fluency-related societal norms and enabled him to talk about stuttering publicly [ref Words Fail us].

A recent composer, poet, and performer who stutters is JJJJerome Ellis. His current practice explores Blackness, music, and disabled speech as forces of refusal and healing. In particular, his work investigates the temporal links between music and stuttering. He argues that music is a beneficial tool of investigation and research for stuttering because of its relationship with time; Ellis finds stuttering opens, stretches, and dilates time [ref youtube video]. In his work, the physical nature of stuttering influences the form of art. For example, Ellis uses musical techniques such as 'loops' and 'rubato' to create alternative temporalities in music. Rubato, the expressive alteration of rhythm or tempo that relies on a certain amount of unpredictability, is argued to resembles Ellis' experience of stuttering: "I don't know when the stutter will arrive, how long it will last, nor when it will leave, only to show up again I don't know when." [ref Journal of Interdisciplinary Voice Studies – The clearing: Music, dysfluency, blackness and time]

Other expressive music elements that take the shape of the physical nature of stuttering include 'turntableism' and 'skipping'. Furthermore, music genres such as popular rock music also took the shape of stuttering in songs such as 'My Generation' by The Who or 'You Ain't Seen Nothing Yet' by Bachman-Turner Overdrive. The repeated staccato syllables found in these two songs generate an element of surprise and desired tension [ref ISAD conf. article]. Finally, notable

musicians that were drawn to music because of their own experiences of stuttering include Carly Simon, Kendrick Lamar, Ed Sheeran, Stormzy (?), and Big Heath. Visual Arts Visual arts have also explored the stuttering aesthetic. A notable visual artist who stutters is painter Paul Aston. His contributions include portraits of people stuttering, such as his self portrait and the portrait 'Stammered Gaze'. Aston conceptualises stuttering thought art by painting people in a celebratory light, showing the diverse ways in which people stutter. In his work, he highlights the unique features of stuttering and challenges fluency by capturing the moments of rare beauty of stuttering [ref Stamily blogpost?].

Another painter who stutters is Vladan Sibinović. His contributions include the exhibition 'The Language', in which he explores the experience of stuttering. The central theme of Sibinović's artwork revolves around exploring the complexities of human beings through art, in particular stuttering [ref his website?].

A graphic designer who stutters is Conor Foran. His contributions include the bespoke typeface 'Dysfluent Mono', in which he explores the voice of stutterers and aesthetics of disfluency [ref Journal of Interdisciplinary Voice Studies]. In Dysfluent Mono, the letterforms stretch and repeat to emulate stuttering. Foran uses the expressive stretches and repetitions to resist conventional representations of dysfluency, giving stuttering its own identity and sense of pride.

Finally, other visual artists who celebrate the stuttering aesthetic include multi-media artist Wendy Ronaldson (Conversation IV), cartoonist Daniele Rossi (Stuttering is Cool) and photographers Alda Villiljos, Sveinn Snaer Kritjansson, and Sigridur Fossberg Thorlacius (Stutters). Performance arts Stuttering is also celebrated by performance artists. A notable performance artist who stutters is stand-up comedian, disability activist, and educator Nina G. In her work, Nina breaks barriers in the comedy world and advocates for the stuttering community. Nina is also the author of autobiographical book ‘Stutterer Interrupted: The Comedian Who Almost Didn't Happen'.

Another performance artist who stutters is theatre performance artist Nye Russell-Thompson. Russell-Thompson created "StammerMouth", a British award-winning theatre company.

Finally, other performance artists who celebrate stuttering include actor and podcaster Scroobius Pip and comedian Callum Schofield.